Scopic procedures are increasingly employed by surgeons to perform relatively major surgery. This permits access to an internal operative site through relatively narrow incisions. Incisions are made, and small tubes referred to as cannulas are inserted providing a passageway to the operative site.
As with most operative procedures, a certain degree of suturing is required. The needle with the thread attached must be placed at the operative site, grasped and manipulated about the operative site to provide the sutures. Such devices must include needle grasping elements, a handle, and a narrow shaft that permits the needle grasping elements to be inside the patient while the handle remains outside the patients.
The needle must be grasped firmly by the needle holder without the needle slipping or rotating during use. Prior needle holders have employed jaw elements which pivot together. With such devices, only a very small portion of the jaw face actually engages the needle. The needle can easily rotate relative to the jaw face.
Further, these needle holders frequently require the surgeon to maintain pressure on the needle holder at all times while the needle is being held. Some include a locking mechanism which must be released. Also, most pivot-jawed needle holders hold the needle in the arc of a curved needle which is not as secure as gripping on the flat plane of the needle.
One needle holder used for laparoscopic procedures is disclosed in U.S. Pat. No. 5,015,250. The disclosed needle holder uses a tube within a tube to hold a needle. The outer tube is notched so that edges of the tubes can contact the needle. This requires an excessively strong spring to hold the needle. Accordingly, it is very tiring. Although it discloses angled jaws, the angled jaws do not permit a needle to be grasped and inserted through a trocar designed for the needle holder.
This can be a particular problem with scopic procedures. The cannula or trocar generally has an internal diameter equal to the external diameter of the needle holder in order to maintain an airtight seal in the operative site. This is required because the operative site is inflated with gas to create a cavity which facilitates viewing of the procedure.
The needle, which is longer than the internal diameter of the cannula, cannot be placed into position by the needle holder. There simply is not enough room to fit the needle through the cannula while grasped by the needle holder. In order to overcome this, special devices have been designed to insert the needle into the operative site. These devices are then removed from the cannula and the needle holder placed in through the cannula.